Agave Matrix LLC
Anesthesiology in Chandler, AZ. Organization (NPI-2).
NPI number1578074209
StatusActive
Last updated in NPPESOct 20, 2017
Details
- NPI
- 1578074209
- Entity type
- Organization (NPI-2)
- Legal business name
- Agave Matrix LLC
- Organization subpart
- No
- Enumeration date
- Oct 20, 2017
- Last updated
- Oct 20, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207L00000X | Anesthesiology | – | – | Yes |
Practice location
1100 S Dobson Rd Ste 204Chandler, AZ 85286-6160
Phone 602-582-5233
Mailing address
2801 Centerville Road, Pmb 650Wilmington, DE 19808
Authorized official
Polly Pollman
Admin
6025825233
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